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2010 Expenses-Update March 20, 2010

Posted by Admin in Cancer, Health Insurance, Healthonymous.
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Insurance changes are trickling in for 2010. First up, only 24 massages per year, or 2 per month from my employer-provided insurance. And this is with a prescription!

(This was, I heard to bring it in line with other “alternative therapies” in the market). Well then. I’ll have to tell my lymphatic system to get on an “alternative” schedule, I guess!

My first compression sleeve of the new year-not covered due to an improper procedure codes. I’ll call my “provider” and see if they need a new code. As far as I know my ICD9 code and prescription on file are sufficient. The cost listed on the “EOB” $194.00. (Explanation of benefits) I need between 2-4 of these per year-as the compression degrades with use. This is a tool to manage my lymphedema.

On the other hand, I just read my first dental EOB more carefully (cleaning, cavity spotting, good grades for flossing-finally and learned that I have orthodontia coverage $1000 of “lifetime” coverage. Hmmmmm. No one is too old for orthodontia anymore-check out your workplace!

In early 2010, I leapt back into the mental health department and found a new therapist.  This costs $90/hour. However, it has been worth it so far. I forgot how helpful just the right question can be-forcing me to consider an answer to a question I had not thought of myself.

Since my weekly out-of-pocket expenses last fall had averaged $90 per week, (see post called Goodbye to 2009 under Expenses) I had taken a holiday from appointments, save the massages, in order to catch up financially.

2010 to date: $150 massage co-pays; $180 for therapist; $194 pending for compression sleeve, $180.22 paid on fall medical bills; $33.80 for initial dental cleaning…..

Total: $738.02 or $67/week for $2010.

Health Care “Providers” and the $30 Co-Pay December 13, 2009

Posted by Admin in Cancer, Diary, Healthonymous, Money.
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In my life, I have had many more health care “providers” than I ever dreamed that I would. In addition to the two excellent surgeons that I had for my cancer surgeries, I have seen people with titles such as dosimetrist, audiologist,  and a gynecological oncologist. I even see phlebotomists regularly (oops, just recalled I need to redo my latest CA 125 blood test-the number was slightly elevated last time).

But the health care job title of the person I enjoy visiting most is that of licensed massage therapist! Regular readers know that I have a prescription for massage to treat my lymphedema. My arm always feels better after and it is usually easier to put my compression sleeve back on too. Yes, after ten years, I still wear mine.

This week’s only expense was my $30 co-pay for my every other week massage. It is very helpful to have someone knowledgeable about manual lymphatic drainage look after me, plus they have two hands to minister with and I feel like a on-armed paper hanger sometimes trying to address my own needs. Ever try to kiss your elbow? Sometimes doing your own lymph massage is just that frustrating.

Tantalizing close, but definitely out of reach!

Expenses out of pocket for week ending December 12th: $30.00


Massage for Lymphedema November 29, 2009

Posted by Admin in Blog Math, Cancer, Diary, Humor, Money.
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[picapp align=”center” wrap=”false” link=”term=health+massage&iid=1134532″ src=”6/0/f/b/Massage_bfe8.jpg?adImageId=7903797&imageId=1134532″ width=”380″ height=”283″ /]

And that method did what?

I could ask my licensed massage therapist to hand me a glass now and then however!

Last week’s expenses: $30 co-pay for massage. Too bad my insurance coverage next year will not take my ICD9 code into consideration for treatment. Monthly totals tomorrow.

Total for Week ending November 27: $30.00

Weekly Expenses November 14, 2009

Posted by Admin in Blog Math, Cancer, Diary, Money.
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I have a doctor’s prescription that allows me to have insurance coverage for my every other weekly massages. Because I have lymphedema, as a result of my mastectomy and lymph node removal, the massage is extremely helpful.

Insurance coverage for anything to do with “complications from a mastectomy” is required by the Women’s Health and Cancer Rights Act of 1998 (see the Department of Labor website  for more information)

This week’s expenses: one $30 co-pay for a massage appointment.

Weekly total: $30

Month to date: $30

By the way, check your coverage changes this month: In 2010, my company coverage for massages and chiropractic care will decrease to 24 sessions a year (“in line with the market”). Never mind the diagnosis or the ICD9 code.

Open Season-er-Open Enrollment November 12, 2009

Posted by Admin in Diary, Health Insurance, Money.
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It’s that time of year again. Open Enrollment. Gone are the days of company meetings, fat glossy brochures and new employee benefits.

Well, I take that back. My employer has added a brokerage option to the 401(k) plan. Which by the way, has no match-but I digress.

Our health care plans have about a 12% increase in them for 2010. I am receiving a 1.5 % raise soon, so that will balance out. In actual dollars, as I am responsible for one person only, my “cost-share” of 15% is still a “good deal”. But as frequent Full Coverage readers can track in the weekly expense posts (search under diary or weekly); my out-of-pocket costs are often 2x/3x higher than the monthly premium.

I just read a column by Ezra Klein who asserts that although productivity per worker is up, all of the wages increases we should have received in the last two or three decades went to health care costs (mostly borne by our employers through action taken in the 1950’s). (Read this post for the 4 accidents that created our current system) He does seem to have a few studies to back him up, so let’s accept the premise for now.

Then he writes about the converse. If health care costs could decrease (that bending the curve thing you might have read about) then it seems there is evidence for the notion that wages might rise again. HR 3962 won’t be bending the curve for at least 3 years though. Sigh.

The traditional fee-for-service model is supposed to begin a transformation under HR 3962. However, due to the recession, I think that our personal productivity will continue to rise in 2010, until each company perceives that it has reached a “tipping point” where they add to staff again. Or not. My current industry may not do that, as their revenues are in sharp decline-in the aggregate.

In September I wrote about how my employer has a section 125 plan for dependent care, transportation costs and medical /dental/vision premiums. But no flexible spending plan where fund can be set aside for over the counter medicines, deductibles and such. I spoke with the correct person and was given the answer that “it had never been part of the discussion”. Maybe next year it will be. With almost no raises, plus furlough days, the company could increase the ways we could reduce our taxes, and to be able to pay the multiple deductibles on a pre-tax basis would be a great addition.

That would be a great way to help me remember the 1980’s and 1990’s when Open Enrollment rolls around again next year.

Weekly Expenses October 17, 2009

Posted by Admin in Blog Math, Diary, Money, Women.
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This has been low cost week, all things considered. On Monday, I had a lymphedema and back massage. The co-pay was $45.00 because it was 90 minutes instead of 60 minutes. Well worth it!

Still waiting for the bill from the emergency room last week-that will be interesting.

Weekly total: $45

September Blog Math October 1, 2009

Posted by Admin in Blog Math, Diary, Money.
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Yesterday was the end of the month.   This blog is not yet one month old, so the numbers for September will not include the days prior to the First Post.

Expenses this week: Massage (for lymphedema) co-pay $30.00

Expenses for the life of the blog(less than 30 days): $680.68

Cost of worry, uncertainty, and bill-juggling (to paraphrase a national commercial) : Priceless!

Percentage of monthly income: Not  a single digit number!

Prediction for next month: Flat (did you know flat is the new up?)

What’s Your ICD9 Code? September 15, 2009

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Not exactly an average pickup line is it? Today I have a massage for my chronic condition and my favorite ICD9 code. These codes date from the 1980’s and a process called Diagnosis-Related Groups.

Or DRG’s. That’s another thing about getting sick is to learn the vocabulary! The code is what the insurance company pays from. I know it  by heart.  After so many procedures, it was just better to memorize it.  My massage therapist doesn’t get paid very much per hour for her time from Insurance Company X, so she charges me an extra co-pay unit. Which I pay because the therapist is trained for my specific condition and is very good at it. Today’s cost $60.00.

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